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September 6, 2023

Pediatric Obesity in a Nutshell

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Image of a young boy sitting on the grass tying his shoe and smiling at the camera

Pediatric obesity…

Pediatric obesity is a chronic, complex, and multifactorial medical condition that is treatable using a comprehensive approach. The prevalence of childhood obesity is rising and affects children and adolescents worldwide. It is often not addressed with professional guidance or current educational resources.

Every child…

Every child deserves to live a healthy life without dealing with obesity and its negative consequences. Why should children carry this burden into their adult years? Healthy children will one day become healthy adults. When we teach healthy habits and reinforce them at a young age, we can break the “vicious cycle of childhood obesity,” which can help prevent adult obesity and its sequelae.

Did you know…

Did you know pediatric obesity places kids and teenagers at risk for chronic health conditions and life-threatening diseases now and in the future? Medical conditions associated with obesity include (but are not limited to) metabolic syndrome, sleep disturbances (obstructive sleep apnea most common), prediabetes, type 2 diabetes, dyslipidemia, hypertension, degenerative joint disease, exercise intolerance, polycystic ovary disease (female), hypogonadism (male), gallbladder disease, cancers, anxiety, depression, poor quality of life, and poor self-esteem.

In terms of the “nutrition pillar”…

Regarding the “nutrition pillar,” it is essential to discuss the foods to limit (saturated fat, salts, sugar, or sweetened beverages). It is also our responsibility to help them learn about healthy food choices (fruits, reduced-fat dairy, protein, vegetables, whole grains, and water).

Activity is vital for health…

Activity is vital for health, so it is discussed in the “physical activity pillar.” It includes biking, dancing, jogging, karate, team sports, swimming, walking, weight training, etc. Sedentary behavior in children is discouraged and includes spending many hours in the car, playing video games, reading, watching TV, using the computer/phone/tablet, etc.

The time to diagnose, monitor, and treat obesity in children is now

Failure to do so is unacceptable and unethical. It is the same as failure to diagnose, treat, and monitor coronary artery disease, diabetes, hyperlipidemia, hypertension, and other chronic medical conditions. So, realize the importance of addressing obesity as a disease, like all the other ones taught in medical schools.

Remember, childhood obesity is a serious matter.

The American Academy of Pediatrics (AAP) pediatric obesity guidelines emphasize that the cornerstone of obesity prevention is risk assessment and anticipatory guidance. For children over the 85th percentile for weight and height (overweight and obesity), the cornerstone of treatment is intensive lifestyle intervention using the broad categories of optimizing nutrition, activity, and behavioral support.

It is imperative…

It is imperative to use a comprehensive approach to obesity prevention and treatment and move beyond BMI percentiles and numbers on the scale.

Choosing a healthy lifestyle is the first defense against obesity in kids and teens.

OMA (Obesity Medicine Association)’s definition of obesity is:

a chronic, relapsing, multifactorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences.”

Since obesity is multifactorial, it needs to be adequately treated, monitored, and managed by qualified healthcare professionals using a comprehensive framework, such as the OMA’s “four pillars of clinical obesity treatment,” which are:

  • nutrition
  • physical activity
  • behavior
  • medication

Behavior is key

Behavior is critical for obesity prevention, management, and treatment in kids and teenagers. In the “behavior pillar,” it is crucial to discuss habits for eating, sleeping, dealing with mood and stressors, and using screening time. Kids and teens must learn to eat based on their body needs rather than emotions. It is encouraged to eat meals together as a family. They also need to have a sound support system (family & friends) that enables them to adopt healthy habits for life. There is an association between childhood obesity and screen time. Today, we live in a world of technology, which is used in schools and at home. Since 2020, many children and adolescents continued to have screen time for many hours daily. Increased screen time may negatively affect children’s weight and metabolic health.

Even children face weight bias and stigma.

The disease of obesity is associated with chronic stress, often exacerbated by weight-based victimization and bullying. For this reason, ongoing assessment is necessary for psychosocial and physiological support. The use of trauma-informed care principles can be beneficial.

September is National Childhood Obesity Awareness Month

It is a dedicated time to sharing information and teaching children and their parents how to prevent childhood obesity and improve their metabolic health. It is a way to raise awareness about obesity, a complex medical condition that can affect the lives of many children. It is also a time to promote educational resources and tools about pediatric obesity.

It is imperative…

It is imperative to remember that patients dealing with obesity need our support, and they need to be heard. They rely on us to be professional resources and partners in health as they maintain or regain their health and well-being. They need our help, time, trust, patience, encouragement, positive attitude, non-judgmental approach, etc.

The 5-2-1-0…

The 5-2-1-0 Healthy Children Initiative is endorsed by the American Academy of Pediatrics (AAP). These guidelines recommend that all children:

  • Consume five fruits and vegetables a day;
  • Limit recreational screen time to 2 hours or less per day;
  • Engage in at least 1 hour of active play;
  • Drink 0 sugar-sweetened beverages.

You, as a trusted health professional…

As a trusted health professional, you can help kids and teens have better health today for a healthier tomorrow. Take action now by learning more about pediatric obesity, using scientific tools to screen children, encouraging them to have healthy behaviors that can last a lifetime, and making a referral to a specialist when needed.

Pediatric Obesity Patient Resources CTA Image

Pediatric Obesity Patient Resources

Short description of how providers can use the resources found in this article to share with patients.

  1. Asham, N; Browne, Nancy. T. (2022, Nov 1). Unraveling Obesity’s pediatric screening tool: the missing piece in childhood obesity prevention. Retrieved from https://nermeen-asham.medium.com/unraveling--pediatric-screening-tool-the-missing-piece-in-childhood-obesity-prevention-4bc58ed018a9
  2. Asham, N. (2021, June 17). OMA’s four pillars: the bedrock of obesity management and treatment. Retrieved from https://obesitymedicine.org/omas-four-pillars-the-bedrock-of-obesity-management-and-treatment/
  3. Asham, N. (2021, Jan 2). The time to diagnose, treat, & monitor patients with pre-obesity and obesity is now. Retrieved from https://nermeen-asham.medium.com/the-time-to-diagnose-treat-monitor-patients-with-pre-obesity-and-obesity-is-now-d6da499cc90
  4. Asham, N. (2019, March 8). Childhood obesity: help children have “a different today for a better tomorrow”. Retrieved from https://nermeen-asham.medium.com/childhood-obesity-help-children-have-a-different-today-for-a-better-tomorrow-fa6ba9456ee
  5. Chandrasekaran, A. (2021, June 30). How screen time can impact sleep & childhood weight gain. Retrieved from https://obesitymedicine.org/how-screen-time-can-impact-sleep-amp-childhood-weight-gain-obesity-medicine-association/
  6. Barlow SE; Expert Committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007 Dec;120 Suppl 4:S164–92. doi: 10.1542/peds.2007–2329C. PMID: 18055651
  7. Goddard A. Adverse Childhood Experiences and Trauma-Informed Care. J Pediatr Health Care. 2021 Mar-Apr;35(2):145–155. doi: 10.1016/j.pedhc.2020.09.001. Epub 2020 Oct 28. PMID: 33129624
  8. Mayo Clinic Staff. Nutrition for kids: guidelines for a healthy diet. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/childrens-health/in-depth/nutrition-for-kids/art-20049335
  9. National Today. National childhood obesity awareness month - september 2023. Retrieved from https://nationaltoday.com/national-childhood-obesity-awareness-month/
  10. Obesity Medicine Association. What is obesity? Retrieved from https://obesitymedicine.org/what-is-obesity/
  11. Puhl RM, Himmelstein MS, Pearl RL. Weight stigma as a psychosocial contributor to obesity. Am Psychol. 2020 Feb-Mar;75(2):274–289. doi: 10.1037/amp0000538. PMID: 32053000
  12. Tan, A. (2016, November 23). Fighting childhood obesity — a clarion call. Retrieved from https://mypositiveparenting.org/2016/11/23/fighting-childhood-obesity-a-clarion-call/
  13. Welia Health. “5210 program” and choose my plate: tools to combat childhood obesity. Retrieved from https://www.weliahealth.org/2019/09/5210-program-and-choose-my-plate-tools-to-combat-childhood-obesity/

Article written by:

Headshot of Nermeen (Nina) Asham, BScN, RN. She is wearing a white coat with a stethoscope around her neck and sitting in front of a tree.

Nermeen (Nina) Asham, BScN, RN

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